When preterm babies 'forget to breathe'

The condition is a developmental disorder. [iStockphoto]

Preterm birth is when a baby is born too early, before 37 weeks of pregnancy have been completed. But what exactly could go wrong when a baby is born prematurely?

One of these things is apnoea of prematurity, a condition that occurs when newborns, especially those born prematurely, stop breathing for short periods of time, according to Johns Hopkins Medicine.

Dr Janette Karimi explains that the condition is a developmental disorder, usually due to the physiological immaturity of a baby’s respiratory control centre in the brain.

Normally, high carbon dioxide in the body signals the brain to increase the breathing rate, but in premature babies, the brain sensitivity to high carbon dioxide is diminished, making pre-mature babies “forget to breathe”.

“Apnoea of prematurity is cessation of breathing for more than 20 seconds. It can also be defined as cessation of breathing for less than 20 seconds associated with a slow heart rate of less than 100, generalised bluish discolouration of the body and the mouth due to low oxygen, and paleness in neonates born at least 37 weeks of gestation and with no other underlying disorders causing apnoea,” explains Dr Karimi, Head, Division of Newborn and Child Health at the Ministry of Health. 

According to Dr Karimi, nearly all pre-terms less than 28 weeks’ gestation, 85 per cent of pre-terms born at 30 weeks’ gestation and 20 per cent of those born at 34 weeks’ gestation develop apnoea of prematurity. 

Despite apnoea being a concern in newborns, Kenyan neonatal death stagnated in the past three years, at 21 neonatal deaths in every 1,000 live births.

Dr Janette Karimi, Head, Division of Newborn and Child Health at the Ministry of Health. 

According to Dr Karimi, reduction in newborn deaths requires great effort in creating community awareness of good nutrition, healthy lifestyle and nutrient supplementation.

Additionally, it requires health system strengthening and investment in both community health systems and health facility workers and equipment.

“There is a need for ensuring women are aware of their health before and during pregnancy, and plan to deliver in a health facility under a skilled health provider,” notes the child health specialist.

Neonatal deaths, she says, occur when a mother does not seek timely access to delivery services because of a lack of awareness of danger signs for her health or that of her unborn baby.

Among danger signs in pregnancy where a mother should go to a health facility immediately for care include vaginal bleeding, severe headache, body swelling in pregnancy, and also reduced or no baby movements.

“Some of the reasons for delay in seeking care by pregnant women include lack of transport vehicle or cost of transport. Lack of basic emergency obstetric and newborn care (BEMONC) equipment, commodities and trained staff at health facilities also contributes to newborn deaths,” notes Karimi.

To avert both infant and maternal deaths, the expert says there is a need for health facilities to be equipped as per the requirement for their level of services to be delivered.

Also, amid the implementation of Universal Health Coverage, she adds that the national and county government should invest in community health promotion services and early referral, in addition to improving the quality of care of mothers in labour and delivery in order to deliver a healthy newborn.

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